A controlled trial of parenteral prophylactic gentamicin therapy in biliary surgery
- 1 April 1975
- journal article
- clinical trial
- Published by Oxford University Press (OUP) in British Journal of Surgery
- Vol. 62 (4), 275-279
- https://doi.org/10.1002/bjs.1800620406
Abstract
This trial has investigated the value of gentamicin therapy in patients requiring biliary surgery. One hundred consecutive patients were randomly allocated to receive either gentamicin or no antibiotic. Postoperative infection was assessed by an independent observer. Cultures and gentamicin assays were performed on bile and blood sampled during and after operation. The minimum inhibitory concentrations of gentamicin were measured with isolated bacteria. In 80 per cent of patients biliary organisms were inhibited by 2μ g/ml of gentamicin. Twice this concentration was found in the serum at operation in 88 per cent, but in the bile in only 18 per cent. Nevertheless, gentamicin lowered the incidence of bacteria in the bile from 42 to 25 per cent. There was a reduction in wound sepsis from 21 to 6 per cent (P<0·05). Bacteriaemia was demonstrated in only 1 patient receiving gentamicin compared with 5 controls and 1 death occurred from endotoxaemia in the control group. These data suggest that gentamicin will reduce the morbidity of biliary surgery, particularly in patients in whom the bile is infected at operation.Keywords
This publication has 17 references indexed in Scilit:
- Preoperative Antibiotics in Biliary SurgeryArchives of Surgery, 1973
- The reduction of surgical wound infections by prophylactic parenteral cephaloridine: A controlled clinical trialBritish Journal of Surgery, 1973
- Causes of failure in antibiotic treatment.BMJ, 1972
- A bacteriological study of the immediate environment of a surgical woundBritish Journal of Surgery, 1971
- Bile-Blood Fistula: A Complication of Percutaneous Transhepatic CholangiographyRadiology, 1969
- The Significance of Biliary Pressure in CholangitisArchives of Surgery, 1969
- Biliary excretion of antibiotics in man.Gut, 1968
- Bacteriologic Studies Of Biliary Tract InfectionAnnals of Surgery, 1967
- PROPHYLACTIC ANTIBIOTIC THERAPYArchives of Surgery, 1955
- DEMONSTRATION OF THE CLOSE RELATIONSHIP BETWEEN BILE CAPILLARIES AND SINUSOID WALLSCells Tissues Organs, 1953